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Early Enteral Nutrition in Paediatric Acute Pancreatitis-A Review of Published Studies
Jan Stanisław Bukowski1, Łukasz Dembiński1, Marcin Dziekiewicz1
1Department of Paediatric Gastroenterology and Nutrition, Medical University of Warsaw, 02-091 Warszawa, Poland.
Insights
Early enteral nutrition (EEN) is safe and beneficial for pediatric acute pancreatitis (AP) patients, potentially reducing hospital stays. Current guidelines for children rely on adult data, highlighting the need for more pediatric-specific research.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Pancreatic Diseases
Background:
- Nutrition is crucial in acute pancreatitis (AP) management.
- Early enteral nutrition (EEN) is established as safe and effective for adult AP.
- Pediatric AP guidelines often extrapolate from adult studies.
Purpose of the Study:
- To review existing literature on the timing of nutritional interventions in pediatric AP.
- To assess the evidence supporting early enteral nutrition in children with AP.
Main Methods:
- A systematic literature search was conducted in April 2022.
- Included were full-text English papers on AP in patients aged 0-21 years.
- Analysis focused on four studies: one RCT, one prospective, and two retrospective chart reviews.
Main Results:
- All included studies supported EEN without delayed initiation for pediatric AP.
- Findings suggest EEN with a regular, normal-fat diet is safe and effective.
- EEN may reduce hospitalization duration in children with mild to moderately severe AP.
Conclusions:
- EEN appears safe and beneficial for pediatric AP, aligning with adult recommendations.
- Current evidence is limited by small sample sizes and study heterogeneity.
- Further prospective randomized controlled trials are necessary to solidify recommendations for pediatric AP nutrition.
Abstract:
Nowadays, nutrition is said to be an integral aspect of acute pancreatitis (AP) treatment. Early enteral nutrition (EEN) is safe and beneficial for patients. This was confirmed by clinical experience and can be found in guidelines on managing adults with AP. Furthermore, paediatric recommendations encourage EEN use in AP. However, paediatric guidelines are based exclusively on studies in adults. Therefore, we present a review of published studies on the time of nutritional interventions in children with AP. A search was independently conducted in April 2022 by two of the authors. Only full-text papers published in English involving children between 0-21 were considered. Only four papers met our inclusion criteria: one randomised-control trial (RCT), one prospective study with retrospective chart review, and two retrospective chart reviews. All studies supported EEN and there was no recommendation of any delay in its initiation. The results of all four papers suggested EEN with a regular, normal-fat diet. EEN is safe in children with mild or moderately severe AP and may decrease the length of hospitalisation. Unfortunately, all the conclusions are based on a small amount of heterogeneous data that are mostly retrospective. Future prospective RCTs are needed.
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